Summary: Mr X complained on behalf of a care provider about the Council’s handling of payments relating to a service user. As part of the complaints process, the Council apologised for causing a delay in increasing payments for the service user from December 2024. It resolved the issue and put steps in place to prevent such delays in future. We found the Council’s response and action to be appropriate, and some parts of Mr X’s complaint related to contractual matters. We have therefore not made any further findings or recommendations.

The complaint

1. The complainant, Mr X, complained on behalf of a care provider which is part of the Intrinsic Care Group.
2. Mr X complained about the Council’s handling of payments to the care provider for its services towards a service user. He said:

• it wrongly refused to backdate nighttime support already provided to the service user;
• enhanced support agreed for the service user in December 2024 remained unpaid;
• it had not provided an uplift in hourly rates for care of the service user over several years; and
• its complaints handling was poor as it failed to acknowledge the complaint, did not respond to everything, and some points were passed to another department to handle.

3. Mr X said, as a result, the care provider had struggled to cover support for the service user and its budgets had been impacted, which made him feel the care provider was not treated as important.

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The Ombudsman’s role and powers

4. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. If there has been fault which has caused significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
5. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)
6. The Local Government Act 1974 sets out our powers but also imposes restrictions on what we can investigate.
7. We cannot investigate a complaint if it is about certain contractual or other commercial transactions. (Local Government Act 1974, Schedule 5/5a, paragraph 3, as amended)
8. The law says we cannot normally investigate a complaint when someone could take the matter to court. However, we may decide to investigate if we consider it would be unreasonable to expect the person to go to court. (Local Government Act 1974, section 26(6)(c), as amended)
9. If we are satisfied with an organisation’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(1), as amended)

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What I have and have not investigated

10. I have considered Mr X’s complaint about the Council’s handling of payments to the care provider as agreed for a service user from December 2024, including how it handled his complaint.
11. I have not investigated:
• Mr X’s concerns about the Council’s refusal to backdate nighttime support which had been provided for a service user. This is because this was not in the service users care plan until December 2024;
• concerns about uplifts in rates payable to the care provider for services provided to service users. This is because the Council explained to Mr X such uplifts are considered as part of a separate contractual process between the care provider (Intrinsic Care Group) and the Council’s commissioning team. This is therefore a contractual dispute which is not for the Ombudsman to consider; and
• any concerns Mr X may have about the service users care support. This is because he does not have consent to act on the service user’s behalf, and there has been no injustice to the service user as the care support continued.

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How I considered this complaint

12. I considered evidence provided by Mr X and the Council as well as relevant law, policy and guidance.
13. Mr X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Relevant law and policy

Care Plans

14. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan (or a support plan for a carer). The care and support plan should consider what needs the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area. When preparing a care and support plan the council must involve any carer the adult has. The support plan must include a personal budget, which is the money the council has worked out it will cost to arrange the necessary care and support for that person.
15. Everyone whose needs the council meets must receive a personal budget as part of the care and support plan. The personal budget gives the person clear information about the money allocated to meet the needs identified in the assessment and recorded in the plan. The council should share an indicative amount with the person, and anybody else involved, at the start of care and support planning. It should confirm the final amount of the personal budget through this process. The detail of how the person will use their personal budget will be in the care and support plan. The personal budget must always be enough to meet the person’s care and support needs.
16. There are three main ways a personal budget can be administered:
• as a managed account held by the council with support provided in line with the person’s wishes;
• as a managed account held by a third party (often called an individual service fund or ISF) with support provided in line with the person’s wishes; or
• as a direct payment.

(Care and Support Statutory Guidance 2014)

Council complaint procedure

17. Councils should have clear procedures to deal with social care complaints. Regulations and guidance say they should investigate and resolve complaints quickly and efficiently. A single stage procedure should be enough. The council should include in its complaint response:
• how it considered the complaint;
• the conclusions reached about the complaint, including any required remedy; and
• whether it is satisfied all necessary action has been or will be taken by the organisations involved; and
• details of the complainant’s right to complain to the Local Government and Social Care Ombudsman.

(Local Authority Social Services and National Health Service Complaints (England) Regulations 2009)

What happened

18. Mr X said a service user moved into the care provider several years ago. A care and support plan was in place, which the Council was funding and paying to the care provider. The support did not include nighttime support.
19. The care provider later started providing the service user with nighttime support. Mr X said the Council was aware of this.
20. In March 2025 Mr X complained to the Council about:
• the care provider had been unable to submit claims for payment for the service user’s nighttime support, which he believed should be backdated;
• the Council had agreed to a request for enhanced care support for the service user and increase the care costs in December 2024, but this had not yet been actioned; and
• the care provider had not had an uplift in its rates paid by the Council since the service user moved in. He said he had previously asked for this but did not receive a response.
21. In response the Council partially upheld Mr X’s complaint. It explained:
• uplifts in rates were dealt with between the Council’s commissioning team and the care provider (Intrinsic Care Group). Mr X or the care provider could contact the Commissioning team to discuss the contractual matters;
• nighttime support for the service user was not agreed prior to December 2024. Therefore, this would not be backdated; and
• the service user’s enhanced support was included in the care and support plan from December 2024. This would therefore be paid to the care provider from this date. It apologised for a delay in putting the proposal to the Integrated Care Board for agreement which was partly due to a change of worker. It had taken steps to ensure staff actioned such requests without delay.
22. Mr X asked the Ombudsman to consider the complaint. He remains unhappy with the Council’s response as he does not feel it apologised and involved other teams instead of him.
23. Following Mr X’s complaint, we have not received further information from him, and my offers of a call has not been responded to. It is therefore presumed the payment issue from December 2024 has been resolved as the Council said it would.

Analysis and findings

Delay in actioning payment in December 2024

24. The Council has accepted it caused delay in actioning the care provider’s request for enhanced support for the service user and action the increased payments to the care provider since December 2024. This was fault.
25. The Council apologised and arranged for this to be actioned without delay. It also explained it had taken steps to ensure such delays did not reoccur through staff reminders.
26. I am satisfied the Council has accepted its fault, and its apology to Mr X was appropriate to remedy the challenges this caused the care provider. It has also taken steps to prevent such delays in the future.
27. As I understand the matter has since been resolved, there is nothing further I can recommend.

Complaints handling

28. I have not found fault in the Council’s complaints handling. While Mr X may not agree with the Council’s apology, or its decisions around the backdating of payments for nighttime support and uplifts in rates, it has explained the reasons for its decisions and how the care provider can request uplifts in rates.

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Decision

29. I find fault by the Council which caused Mr X some frustration. Its apology and action to prevent delays were appropriate to remedy this. Other parts of Mr X’s complaint were not for the Ombudsman to consider.

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Investigator's decision on behalf of the Ombudsman